Collaborative ECHO research led by Izzuddin M. Aris, PhD of Harvard Medical School, investigates associations between neighborhood-level opportunity and social vulnerability and children’s body mass index (BMI) and obesity risk. The study evaluated over 20,000 children and found that children who lived in higher opportunity or less vulnerable neighborhoods early in life had lower average BMI and lower risk of obesity from childhood to adolescence. Children’s BMI and obesity risk was most strongly linked with the conditions of the neighborhoods they lived in at birth compared to those they lived in later in childhood. Additionally, these associations were not affected by individual and family sociodemographics or by prenatal characteristics that are considered risk factors for childhood obesity. This research, titled “Associations of Neighborhood Opportunity and Vulnerability with Trajectories of Child Body Mass Index and Obesity Among U.S. Children,” is published in JAMA Network Open.
Childhood BMI—an estimation of their overall body fat—and childhood obesity are significant risk factors for cardiovascular disease-related morbidity and mortality later in adulthood. To understand how neighborhood-level conditions can affect a child’s risk for these health outcomes, this study looked at children from 54 ECHO cohorts located across the United States. ECHO researchers collected each child’s home address and weight at birth, infancy (6 months‒1.5 years), early childhood (2‒5 years), and mid-childhood (5‒10 years). The researchers linked children’s addresses throughout childhood to data from the Child Opportunity Index and Social Vulnerability Index to examine links between neighborhood conditions and children’s BMI and obesity over time.
“Our findings suggest that living in a high opportunity or low vulnerability neighborhood is an important resilience factor that may promote favorable BMI patterns which, in turn, could reduce future chronic disease risk,” said Dr. Aris. “This study bolsters the need for a focus on investments that address the structures that consistently compromise the health of marginalized communities.”
Neighborhood indices, such as the ones used in this study, could be used to target the development of place-based programs or policies that directly address the disparate contexts of neighborhoods, reduce barriers and improve access to essential resources and provide families with the environments needed to support optimal child health and well-being.
Future research should explore whether programs or policies that change specific aspects of neighborhood environments would be effective in preventing excess weight and obesity in children.